Physiotherapeutic Approach in Stress Urinary Incontinence with Prolapsed Uterus: A Case Report

Abstract

The International Continence Society (ICS) describes incontinence as an objectively demonstrable loss of urine which is not voluntary and that is a social and/or sanitary issue. The complaint of leakage of urine, which is not voluntary on an effort made, on exertion, on sneezing or while coughing is described as Stress urinary incontinence (SUI). The intra-abdominal increases as the effort or exertion increases, and the urethral sphincter is not capable to sustain a pressure greater than the pressure applied on the urinary bladder. Eventually, leakage of urine occurs during the daily activities like lifting, laughing, jumping, while sneezing or coughing. In women, stress urinary incontinence is most common category of incontinence of urine. Even though it isn’t a lethal illness. SUI has a number of negative effects on women's quality of life, including restricting social interaction and relationship and the personal relationships but also physical activity. Cystocele is the weakness of pubocervical fascia, which makes the urinary bladder to descend downwards and backwards against the anterior wall of the vagina. If this is a not taut then it will protrude. In more extreme cases a pouch of bladder sets up which holds on to the residual urine. The conservative treatment, a nonsurgical therapy, includes ameliorating the living standards, urinary bladder training, pelvic floor muscle exercises and strengthening. Kegel exercises are the most effective form of strengthening muscles of pelvic floor in addition are a noninvasive therapy and the use of vaginal weights or cones are not included. The rehabilitation and strengthening muscles of pelvic floor is facilitated and promote urine storage. The combination of Kegel’s exercise along with other interventions for a span of six weeks has shown a significant improvement in the symptoms.